Gates Open Research最新文献

{"title":"Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial.","authors":"Melanie Pleaner, Alison Kutywayo, Mags Beksinska, Khuthala Mabetha, Nicolette Naidoo, Saiqa Mullick","doi":"10.12688/gatesopenres.13636.3","DOIUrl":"10.12688/gatesopenres.13636.3","url":null,"abstract":"<p><strong>Background: </strong>South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings.</p><p><strong>Methods: </strong>A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake.</p><p><strong>Results: </strong>In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex.</p><p><strong>Conclusion: </strong>This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"6 ","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10213203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using models and maps to inform Target Product Profiles and Preferred Product Characteristics: the example of <i>Wolbachia</i> replacement.","authors":"Katie Tiley, Julian Entwistle, Bruce Thomas, Laith Yakob, Oliver Brady","doi":"10.12688/gatesopenres.14300.3","DOIUrl":"https://doi.org/10.12688/gatesopenres.14300.3","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of diseases transmitted by <i>Aedes aegypti</i> mosquitoes, such as dengue, Zika and Yellow Fever, is increasing, but development of promising new mosquito control technologies could reverse this trend. Target Product Profiles (TPPs) and Preferred Product Characteristics (PPCs) documents issued by the World Health Organization can guide the research and development pathways of new products and product combinations transitioning from proof of concept to operational use.</p><p><strong>Methods: </strong>We used high resolution global maps of the case and economic burden of dengue to derive programmatic cost targets to support a TPP for <i>Wolbachia</i> replacement. A compartmental entomological model was used to explore how release size, spacing and timing affect replacement speed and acceptability. To support a PPC for a hybrid suppress-then-replace approach we tested whether <i>Wolbachia</i> replacement could be achieved faster, more acceptably or at a lower cost if preceded by a mosquito suppression programme.</p><p><strong>Results: </strong>We show how models can reveal trade-offs, identify quantitative thresholds and prioritise areas and intervention strategies for further development. We estimate that for <i>Wolbachia</i> replacement to be deployable in enough areas to make major contributions to reducing global dengue burden by 25% (in line with 2030 WHO targets), it must have the potential for cost to be reduced to between $7.63 and $0.24 (USD) per person protected or less. Suppression can reduce the number of <i>Wolbachia</i> mosquitoes necessary to achieve replacement fixation by up to 80%. A hybrid approach can also achieve fixation faster and potentially improve acceptability, but may not justify their cost if they require major new investments in suppression technologies.</p><p><strong>Conclusions: </strong>Here we demonstrate the value dedicated modelling can provide for interdisciplinary groups of experts when developing TPPs and PPCs. These models could be used by product developers to prioritise and shape development decisions for new <i>Wolbachia</i> replacement products.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"68"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable ultrasound devices for obstetric care in resource-constrained environments: mapping the landscape.","authors":"Bryan J Ranger, Elizabeth Bradburn, Qingchao Chen, Micah Kim, J Alison Noble, Aris T Papageorghiou","doi":"10.12688/gatesopenres.15088.2","DOIUrl":"https://doi.org/10.12688/gatesopenres.15088.2","url":null,"abstract":"<p><strong>Background: </strong>The WHO's recommendations on antenatal care underscore the need for ultrasound assessment during pregnancy. Given that maternal and perinatal mortality remains unacceptably high in underserved regions, these guidelines are imperative for achieving better outcomes. In recent years, portable ultrasound devices have become increasingly popular in resource-constrained environments due to their cost-effectiveness, useability, and adoptability in resource-constrained settings. This desk review presents the capabilities and costs of currently available portable ultrasound devices, and is meant to serve as a resource for clinicians and researchers in the imaging community.</p><p><strong>Methods: </strong>A list of ideal technical features for portable ultrasound devices was developed in consultation with subject matter experts (SMEs). Features included image acquisition modes, cost, portability, compatibility, connectivity, data storage and security, and regulatory certification status. Information on each of the devices was collected from publicly available information, input from SMEs and/or discussions with company representatives.</p><p><strong>Results: </strong>14 devices were identified and included in this review. The output is meant to provide objective information on ideal technical features for available ultrasound systems to researchers and clinicians working in obstetric ultrasound in low-resource settings. No product endorsements are provided.</p><p><strong>Conclusions: </strong>This desk review provides an overview of the landscape of low-cost portable ultrasound probes for use in obstetrics in resource-constrained environments, and provides a description of key capabilities and costs for each. Methods could be applied to mapping the landscape of portable ultrasound devices for other clinical applications, or may be extended to reviewing other types of healthcare technologies. Further studies are recommended to evaluate portable ultrasound devices for usability and durability in global field settings.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"133"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding evidence ecosystems: What influences the production, translation, and use of modeled evidence in Burkina Faso, Nigeria, India, and Kenya?","authors":"Ali Sié, Habibou Fofana, Moubassira Kagoné, Moussa Ouédraogo, Obinna E Onwujekwe, Chinyere O Mbachu, Maulik Chokshi, Latha Chilgod, Tushar Mokashi, Arun B Nair, Peter Muriuki, Abeba Taddese, Leah Ewald, Apoorva Handigol","doi":"10.12688/gatesopenres.14973.2","DOIUrl":"https://doi.org/10.12688/gatesopenres.14973.2","url":null,"abstract":"<p><strong>Background: </strong>This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations.</p><p><strong>Methods: </strong>The study used sequential mixed methods drawing on data collected from surveys and key informant interviews, complemented by a rapid desk review to map modeling activities and actors. The survey was conducted online while the qualitative research entailed in-depth interviews with modelers, knowledge brokers, and decision-makers working in a representative variety of health fields, organizations, and levels of government. This study was approved by Health Media Lab IRB (Institutional Review Board) in the United States and a local IRB in each study country and conducted between September 2021 and June 2022.</p><p><strong>Results: </strong>Informants interviewed for this study described a range of factors that facilitate and inhibit the use of modeled evidence in public health decision-making at the individual, organizational, and environmental levels. Key themes included the capacity to produce, translate, and use modeled evidence; the timing and relevance of modeling outputs; the existence of communications channels between modelers and decision-makers; the strength of underlying data systems; the role of sustained funding; and the impact of global crises.</p><p><strong>Conclusion: </strong>This study highlights the importance of taking an ecosystem approach to supporting modeling activities, considering individual, organizational, and environmental factors and how different actors and interact to inform the production, translation, and use of modeled evidence. Structured interaction that promotes dialogue, debate, and joint sense making between the producers and users of evidence is critical to informing and influencing the use of evidence in decision-making.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"135"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine decision-making among pregnant women: a protocol for a cross-sectional mixed-method study in Brazil, Ghana, Kenya and Pakistan.","authors":"Jessica L Schue, Prachi Singh, Berhaun Fesshaye, Emily S Miller, Shanelle Quinn, Ruth A Karron, Renato T Souza, Maria Laura Costa, Jose Guilherme Cecatti, Kwasi Torpey, Caroline Dinam Badzi, Emefa Modey, Chris Guure, Ferdinand Okwaro, Marleen Temmerman, Saleem Jessani, Sarah Saleem, Muhammad Asim, Sidrah Nausheen, Haleema Yasmeen, Grace Belayneh, Vanessa Brizuela, Sami Gottlieb, Rupali J Limaye","doi":"10.12688/gatesopenres.16280.2","DOIUrl":"10.12688/gatesopenres.16280.2","url":null,"abstract":"<p><p>Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited from either 2 or 3 maternity hospitals and/or clinics that represent a diverse population in terms of socio-economic and urban/rural status. Data collection includes cross-sectional surveys in pregnant women and semi-structured in-depth interviews with both pregnant and postpartum women. The instruments were designed to identify attitudinal, behavioral, and social correlates of vaccine uptake during and after pregnancy, including the decision-making process related to COVID-19 vaccines, and constructs such as risk perception, self-efficacy, vaccine intentions, and social norms. The aim is to recruit 400 participants for the survey and 50 for the interviews in each country. Qualitative data will be analyzed using a grounded theory approach. Quantitative data will be analyzed using descriptive statistics, latent variable analysis, and prediction modelling. Both the quantitative and qualitative data will be used to explore differences in attitudes and behaviors around maternal immunization across pregnancy trimesters and the postpartum period among and within countries. Each country has planned dissemination activities to share the study findings with relevant stakeholders in the communities from which the data is collected and to conduct country-specific secondary analyses.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142462816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated data for census-scale entity resolution research without privacy restrictions: a large-scale dataset generated by individual-based modeling.","authors":"Beatrix Haddock, Alix Pletcher, Nathaniel Blair-Stahn, Os Keyes, Matt Kappel, Steve Bachmeier, Syl Lutze, James Albright, Alison Bowman, Caroline Kinuthia, Zeb Burke-Conte, Rajan Mudambi, Abraham Flaxman","doi":"10.12688/gatesopenres.15418.2","DOIUrl":"10.12688/gatesopenres.15418.2","url":null,"abstract":"<p><strong>Background: </strong>Entity resolution (ER) is the process of identifying and linking records that refer to the same real-world entity. ER is a fundamental challenge in data science, and a common barrier to ER research and development is that the data fields used for this fuzzy matching are personally identifiable information, such as name, address, and date of birth. The necessary restrictions on accessing and sharing these authentic data have slowed the work in developing, testing, and adopting new methods and software for ER. We recently released <i>pseudopeople</i>, a Python package that allows users to generate simulated datasets with configurable noise approaching the scale and complexity of the data on which large organizations and federal agencies, like the US Census Bureau regularly perform ER. With pseudopeople, researchers can develop new algorithms and software for ER of US population data without needing access to personal and confidential information.</p><p><strong>Methods: </strong>We created the simulated population data available for noising with pseudopeople using our Vivarium simulation platform. Our model simulates individuals and their families, households, and employment dynamics over time, which we observe through simulated censuses, surveys, and administrative data collection systems.</p><p><strong>Results: </strong>Our simulation process produced over 900 gigabytes of simulated censuses, surveys, and administrative data for pseudopeople, representing hundreds of millions of simulants. A sample simulated population of thousands of simulants is now openly available to all users of the pseudopeople package, and large-scale simulated populations of millions and hundreds of millions of simulants are also available by online request through GitHub. These simulated population data are structured for use by the pseudopeople package, which includes additional affordances to add various kinds of noise to the data to provide realistic, sharable challenges for ER researchers.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stories of women's marriage and fertility experiences: Qualitative research on urban and rural cases in Bali, Indonesia.","authors":"Anastasia Septya Titisari, Luh Kadek Ratih Swandewi, Carol Warren, Anja Reid","doi":"10.12688/gatesopenres.14781.2","DOIUrl":"https://doi.org/10.12688/gatesopenres.14781.2","url":null,"abstract":"<p><p>As a Hindu-majority province in Indonesia, Bali presents a unique and distinctive culture. Patrilocal ( <i>purusa</i>) marriage and patrilineal inheritance as a continuation of the patriarchal system puts a male in the key role of family representative and successor. Having a son is a priority for a married couple in Balinese society. As a consequence, Balinese women experience several constraints related to their economic productive, reproductive, and <i>adat</i> (ritual) roles. When a family does not have a male heir, their daughter is pressed to find a spouse willing to accept <i>sentana</i> (daughter succession) marriage. This secondary form of marriage brings another complication for Balinese-Hindu women and does not necessarily relieve their submissive position. This study analyzes Balinese-Hindu women's perspectives on their marriage experiences and fertility decisions in patrilineal society in changing rural and urban conditions. The data was collected in two areas representing rural (Gianyar) and urban (Denpasar) locations in Bali Province, Indonesia from November 2019 to February 2020. Primary data was based on in-depth interviews of six rural and six urban married Balinese-Hindu women. This qualitative inquiry into Balinese women's experience of the marriage system and fertility options in urban and rural Bali revealed varying degrees of social expectation to provide male descendants for their families. At the same time, economic burdens still haunted them in this development era and manifested conflicting implications for family size. Their stories of <i>purusa</i> and <i>sentana</i> marriage were complex because it has strongly associated with customary law ( <i>adat</i>) in traditional society. Paradoxically, this study found that it was predominantly rural women who opted for the <i>sentana</i> arrangement and expressed a preference for smaller family sizes. This study explores women's fertility aspirations, notably regarding son precedence. It problematizes the <i>sentana</i> marriage alternative as a potential solution to alleviate the expectations and burdens placed on women.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"124"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142462758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasectomy provider decision-making balancing autonomy and non-maleficence: qualitative interviews with providers.","authors":"Alison T Hoover, Dominick Shattuck, Karen L Andes","doi":"10.12688/gatesopenres.15036.2","DOIUrl":"https://doi.org/10.12688/gatesopenres.15036.2","url":null,"abstract":"<p><strong>Background: </strong>Male sterilization, or vasectomy, is 99.9% effective at preventing pregnancy with less than a 2% risk of complications. Despite the high efficacy, low risk, low cost, and gender equity benefits of vasectomy, just 2% of women reported that they and their partners relied on vasectomy as their contraceptive method globally in 2019. Health care providers can be both a facilitator and a barrier in men's health generally, and may be in vasectomy provision as well. This study sought to describe the decision-making rationales of experienced vasectomy providers when evaluating patient candidacy in complex cases.</p><p><strong>Methods: </strong>Fifteen vasectomy providers belonging to the global Vasectomy Network Google Group from seven countries participated in online interviews using a semi-structured in-depth interview guide. Providers were asked about their vasectomy training, their reasons for vasectomy provision, challenging cases they have faced, and approaches used to manage challenging cases. Vignettes were used to further elicit decision-making rationale. Thematic analysis was conducted using MAXQDA20.</p><p><strong>Results: </strong>Provider decision-making was predicated on ensuring patients were well-informed, able to consent, and certain about their choice to have a vasectomy. Once those foundational conditions were met, providers filtered patient characteristics through their training, laws and policies, sociocultural norms, experience, and peer influence to produce a cost-benefit breakdown. Based on the cost-benefit analysis, providers determined whether to weigh autonomy or non-maleficence more heavily when determining vasectomy patient candidacy.</p><p><strong>Conclusions: </strong>Despite clinical best practices that promote prioritizing patient autonomy over non-maleficence, some providers continued to weigh non-maleficence over autonomy in vasectomy patient candidacy evaluations. Non-maleficence was particularly prioritized in cases providers deemed to be at higher risk of regret. The findings of this study suggest vasectomy provider training should emphasize evidence-based best practices in shared decision-making and patient-centered care to facilitate vasectomy provision that honors patient autonomy and rights.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"132"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care-seeking behavior for childhood illnesses in western Kenya: Qualitative findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) Study.","authors":"Sarah Ngere, Maria Maixenchs, Sammy Khagayi, Peter Otieno, Kennedy Ochola, Kelvin Akoth, Aggrey Igunza, Benard Ochieng, Dickens Onyango, Victor Akelo, John Blevins, Beth A Tippett Barr","doi":"10.12688/gatesopenres.14866.3","DOIUrl":"10.12688/gatesopenres.14866.3","url":null,"abstract":"<p><strong>Background: </strong>Child mortality in Kenya is 41 per 1,000 live births, despite extensive investment in maternal, newborn, and child health interventions. Caregivers' health-seeking for childhood illness is an important determinant of child survival, and delayed healthcare is associated with high child mortality. We explore determinants of health-seeking decisions for childhood illnesses among caregivers in western Kenya.</p><p><strong>Methods: </strong>We conducted a qualitative study of 88 community members between April 2017 and February 2018 using purposive sampling in an informal urban settlement in Kisumu County, and in rural Siaya County. Key informant interviews, semi-structured interviews and focus group discussions were performed. We adopted the Partners for Applied Social Sciences model focusing on factors that influence the decision-making process to seek healthcare for sick infants and children. The discussions were audio-recorded and transcribed. Data management was completed on <i>Nvivo®</i> software. Iterative analysis process was utilized and themes were identified and collated.</p><p><strong>Results: </strong>Our findings reveal four thematic areas: Illness interpretation, the role of social relationship on illness recognition and response, medical pluralism and healthcare access. Participants reported some illnesses are caused by supernatural powers and some by biological factors, and that the illness etiology would determine the health-seeking pathway. It was common to seek consensus from respected community members on the diagnosis and therefore presumed cause and necessary treatment for a child's illness. Medical pluralism was commonly practiced and caregivers would alternate between biomedicine and traditional medicine. Accessibility of healthcare may determine the health seeking pathway. Caregivers unable to afford biomedical care may choose traditional medicine as a cheaper alternative.</p><p><strong>Conclusion: </strong>Health seeking behavior was driven by illness interpretation, financial cost associated with healthcare and advice from extended family and community. These findings enrich the perspectives of health education programs to develop health messages that address factors that hinder prompt health care seeking.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Life mapping\" exploring the lived experience of COVID-19 on access to HIV treatment and care in Malawi.","authors":"Jane Harries, Ruby T Zolowere, Khokhelwa Zokwana, Krista Lauer, Jelena Bozinovski, Solange L Baptiste","doi":"10.12688/gatesopenres.15927.2","DOIUrl":"10.12688/gatesopenres.15927.2","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic in Malawi exacerbated, existing public health challenges including access to HIV treatment and care services. \"Life Mapping,\" a component of the Citizen Science community-led project in Malawi, documented the lived experiences and perspectives of people living with HIV in the context of COVID-19.</p><p><strong>Methods: </strong>Citizen Science Life Maps is a three-year qualitative, longitudinal project utilizing collaborative and participatory research methods through digital storytelling to document peoples' daily lives. Twenty participants living with HIV were recruited between 2022 and 2023 in two central regional districts of Malawi and two urban areas. The participants were given mobile smart phones to document the impact of COVID-19 on HIV prevention and treatment services, HIV treatment literacy, mental health and the COVID -19 vaccine. Data was analyzed using a thematic analysis approach.</p><p><strong>Results: </strong>Access to HIV prevention and treatment slowly recovered yet introducing multi-month anti- retroviral dispensing raised concerns. In the absence of mental health care services, participants were resourceful in seeking alternative ways to deal with mental health. However, state sponsored violence in relation to COVID-19 public health measures impacted negatively not only on mental well-being but also on HIV treatment adherence. Whilst most recognized the importance of the COVID-19 vaccine, especially for people living with HIV, myths, misinformation, and conspiracy theories around the vaccine persisted especially religious themed misinformation.</p><p><strong>Conclusions: </strong>The relationship between misinformation and COVID-19 vaccine hesitancy is complex and medical and scientific approaches may not be sufficient to prevent misinformation. Fear and misinformation are likely attributed to global uncertainty during the pandemic and the speed at which vaccines were developed with minimal opportunity to prepare global communities.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"70"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}